Schizophrenia - General Discussion

Olivia Bishop8 said:So, what happens if someone with F20 just decides to stop taking their meds on their own? Like, they've been off them for 9 months now... 😬

Look, you can technically exist without medication, but there’s always that looming question of when things are going to go south. Even when I’m strictly following my regimen—which I have been, religiously, for nine years now—I’ve still had episodes that landed me in the psych ward.

Someone on an American Forum actually explained our situation to my mom once regarding what we could do about it. It’ll probably be some small amount of assistance. Honestly, I don't even know if we'll bother applying. We’ve basically been treated as a social services case for years, living with zero real income. My mom just did her best to scrape by and keep us afloat.

Can you walk me through what those outbursts actually look like?

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cosmiclynx79 said:Can you walk me through what those outbursts actually look like?

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It’s tough to recount, but I’ll give it a shot. Back in 2012, I had an episode in the internal medicine ward while I was there for some intense tests. I’d had way too much Starbucks—overdid it, I guess—and was feeling a bit jittery, just slightly restless. I ended up getting into this whole debate with the staff in my room about "floaters"—basically seeing my own blood cells, which I know now were actually white blood cells. One of the staff members told me the administration would just label me crazy if I kept it up. They didn't really have a choice but to move me to psych because I just wouldn't settle down.

Then in 2013, things got a little intense with my religious beliefs. I sort of snapped, bolted out of my apartment, then ended up out in the street where I actually got hit by a car. It wasn't a suicide attempt, though.

2016? Honestly, I can't quite place what happened. Maybe an argument with my family. I couldn't convince them that tethering my phone to a USB stick for data was cheaper than just using mobile hotspots—and that I'd get better coverage that way. Typical stuff.

In 2018, another spat with my folks. Can't remember the specifics.

During 2020 and 2021, I was hospitalized twice due to heart issues related to the Coronavirus. The first time, I was terrified my cousin wouldn't be able to speak for herself or us, and that we’d end up starving. The second time, I just lost my grip on reality and was talking total nonsense. I didn't even recognize a girl from my old school when she was the one treating me in the ER.

That adds up to 7 hospitalizations in 9 years. And honestly, looking at the state of things, we might actually go hungry. My mom and I don't have any steady income, and she hasn't been able to work for almost three months now. We're stuck waiting three months for my benefits to kick in, meanwhile, our utility bills are a complete disaster—even though they used to garnish more than half of my late father's Social Security check to cover them.

Some of those stays were voluntary, others... not so much.

Regarding the topic, it seems like schizophrenia and autism are pretty closely linked. Some institute in Tel Aviv supposedly uncovered it. Just search Google for "Schizophrenia is Autism."

At this rate, we'll probably find out we're all on the spectrum too.

Edit: I'm missing one year and one hospitalization from the tally.

Too many conditions are being lumped together under the umbrella of schizophrenia, which leads me to believe that autism shouldn't be categorized alongside it. Don't you think it's time we re-evaluated how illnesses under the F20.XX classification are organized?

The French psychiatric school used to treat paranoia as its own distinct entity, separate from schizophrenia.

On another note... is anyone here currently taking the hypnotic Mirtazapine? My psychiatrist prescribed it to me, and I have to admit, I'm feeling a bit apprehensive about it. I was on Trittico for a month, and I experienced excessive salivation at night followed by intense dryness in the morning—something that never happened before I started the Trittico. I was taking doses between 25-50mg, though the tablets come in 75mg; they even make 150mg versions, but I haven't tried those yet.

And let’s not forget that Trittico comes with quite an extensive list of potential side effects. It functions primarily as an antidepressant, though it acts as a hypnotic when administered in lower doses.

I find myself feeling quite forgetful and unable to concentrate since I started the Trittico.

Paranoid schizophrenia is actually the most common type—and generally much more manageable than other clinical forms—yet people still get it wrong. It isn’t hereditary, and for heaven's sake, it certainly isn't the same thing as autism. I’d highly recommend doing a bit more reading—ideally diving into literature from a wide variety of sources.

steelskipper9 said:Paranoid schizophrenia is actually the most common type—and generally much more manageable than other clinical forms—yet people still get it wrong. It isn’t hereditary, and for heaven's sake, it certainly isn't the same thing as autism. I’d highly recommend doing a bit more reading—ideally diving into literature from a wide variety of sources.

The thing is, I don't even think what I have is paranoid schizophrenia—maybe it's just some unspecified version. I mean, I don't deal with paranoia, like thinking someone is out to get me or anything like that.

I was watching that series > recently, and I really felt a connection to one of the characters. I act a lot like him, except for the fact that I can't even leave my own neighborhood without someone coming along—mostly because I just don't know how to navigate things on my own.

There are even basic, everyday tasks that I struggle to handle completely solo without some kind of help.

Look, I know I'm struggling mentally—and physically, I'm not exactly at 100% either—so I'm not sitting here denying that I'm mentally ill. I get it, I accept it. I just don't think it's paranoid schizophrenia.

So, what specific code are they actually putting on your lab results and discharge papers? Is it F20. XX?

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mellowskipper said:So, what specific code are they actually putting on your lab results and discharge papers? Is it F20. XX?

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It started out listed as acute and transient psychosis—then later, under that same heading, they added "with schizophrenic features." After I sat down for a session with the hospital psychologist while I was still on heavy meds, she officially slapped me with a diagnosis of paranoid schizophrenia.

Even though I don't have—and I'm repeating this, I really don't—any paranoia or hallucinations.

I’ve just had ideas for a long time. Back when I was a kid during the war, I used to come up with these little games involving blocks. Stuff like soccer or some kind of strategic military game. Unfortunately, I didn't save any of that, so those specific games are gone, but since 2008, I've been scribbling ideas in notebooks—and since 2016, I've been using my laptop, even though I actually got it as a gift back in 2014.

I mentioned all this to the doctor at the evaluation board and brought my notebooks so he could see some of the more recent stuff. I brought up that old idea about a vacuum bomb, plus a new one about a teleportation bridge and pathway, and showed him an idea for a game. Well, he wrote in his official report that I have "delusional ideas," specifically citing the vacuum bomb and the teleportation stuff.

Just for the record, those aren't crazy to me. I actually have a whole folder now—labeled "My Ideas and Craziness"—where I keep everything I think is actually logical and sound.

Are you currently on any kind of medication?

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mellowskipper said:Are you currently on any kind of medication?

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I’ve been on various meds consistently for nine years now—just part of the routine at this point. I've cycled through different stuff over the years, too. Right now, I’m taking Unknown here in the US along with Unknown. They used to have me on Seroquel and some kind of Pin as well, but they cut both of those out because the Seroquel was making my legs swell up like crazy, and the Pin was probably causing some skin irritation or itching.

Even now, I still wake up with this itchy feeling all over... honestly, I don't think it's coming from the Unknown.

I don't buy for a second that you're reacting to Seroquel. It’s more likely some kind of allergy—food, maybe? Or feathers, pet dander, laundry detergent, fabric softener... even just a specific soap you've started using. I guess you could try keeping a little log of what you encounter to see if you can eliminate things one by one...

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mellowskipper said:I don't buy for a second that you're reacting to Seroquel. It’s more likely some kind of allergy—food, maybe? Or feathers, pet dander, laundry detergent, fabric softener... even just a specific soap you've started using. I guess you could try keeping a little log of what you encounter to see if you can eliminate things one by one...

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It's fine now. It just itches a bit in the morning. I can deal with it. Besides, who's going to know what caused it? It'll be pretty much impossible to pin down.

Hello there, my dear fellow travelers! :-)
I have a quick question for the group. About a year and a half ago, I started taking an antipsychotic, and since then, I’ve noticed a significant drop in my libido. I'm 46—not in menopause yet, and I don't currently have a partner—but regardless, I'd really love to move past this side effect. My doctor is a good man, truly, but he has such a strict, authoritative presence that I find it difficult to even bring up a complaint. Are any of you dealing with this too? Specifically, I'm wondering about women who might be experiencing this but aren't necessarily speaking up about it. From what I've been reading, this could be linked to hyperprolactinemia—which isn't something I can see outwardly, but they seem connected. And, theoretically, that can lead to an increased risk of breast cancer. Now, I actually feel quite good on the medication itself. It almost feels like when you're on antipsychotics, you just have to accept certain side effects and learn to live with them—since every single medication comes with its own set of baggage. You just decide which trade-offs are worth it. Still, it's been weighing on my mind.

steelskipper9 said:Hello there, my dear fellow travelers! :-)
I have a quick question for the group. About a year and a half ago, I started taking an antipsychotic, and since then, I’ve noticed a significant drop in my libido. I'm 46—not in menopause yet, and I don't currently have a partner—but regardless, I'd really love to move past this side effect. My doctor is a good man, truly, but he has such a strict, authoritative presence that I find it difficult to even bring up a complaint. Are any of you dealing with this too? Specifically, I'm wondering about women who might be experiencing this but aren't necessarily speaking up about it. From what I've been reading, this could be linked to hyperprolactinemia—which isn't something I can see outwardly, but they seem connected. And, theoretically, that can lead to an increased risk of breast cancer. Now, I actually feel quite good on the medication itself. It almost feels like when you're on antipsychotics, you just have to accept certain side effects and learn to live with them—since every single medication comes with its own set of baggage. You just decide which trade-offs are worth it. Still, it's been weighing on my mind.

Please, do not hesitate to speak up about this specific side effect, for how can one truly flourish when such a fundamental aspect of life is diminished? Over the long term, this lack of desire can severely impact your overall quality of life and lead to mounting frustration. Is it not his duty to listen intently to your concerns and work alongside you to find a solution? While the medication might mean your libido won't return to its former peak, suffering a total absence of desire is simply unacceptable.

Perhaps you feel a sense of embarrassment because he is a man, but should you really allow that hesitation to stand in the way of your well-being?

Nicole Barrett76 said:Please, do not hesitate to speak up about this specific side effect, for how can one truly flourish when such a fundamental aspect of life is diminished? Over the long term, this lack of desire can severely impact your overall quality of life and lead to mounting frustration. Is it not his duty to listen intently to your concerns and work alongside you to find a solution? While the medication might mean your libido won't return to its former peak, suffering a total absence of desire is simply unacceptable.

Perhaps you feel a sense of embarrassment because he is a man, but should you really allow that hesitation to stand in the way of your well-being?

Thanks for the support, Nicole Barrett76. 👍
My biggest fear is that he’ll just tell me the benefits of the medication outweigh the downsides—and then I'll just end up feeling foolish for even asking. After all, I was only prescribed this because I hit a massive relapse after about ten years of being totally stable. It was essentially a "stop the bleeding" moment—like emergency responders rushing into a building to save people at the very last second—since I ended up checking myself into the hospital after complaining to my primary care doctor and the ER three separate times that things weren't right.

Anyway, I'm going to copy and paste a translation of an article from PubMed here— https://pubmed.ncbi.nlm.nih.gov/23928066/

Prolactin is a hormone secreted by lactotroph cells in the anterior pituitary gland. Its synthesis and release are regulated by various peptides, steroids, and neurotransmitters. The primary inhibitory regulation comes from dopamine, which binds to D2 dopamine receptors on the membrane of lactotroph cells. Antipsychotic drugs block these receptors, thereby removing dopamine's inhibitory effect on prolactin secretion. While all antipsychotics block D2 receptors and can induce hyperprolactinemia, it appears that the faster an antipsychotic dissociates from the D2 receptor, the lower the rise in plasma prolactin levels. Another explanation for hyperprolactinemia involves the ability of the antipsychotic to cross the blood-brain barrier, along with the role of its metabolites. Consequently, antipsychotics can be categorized into those that elevate prolactin (conventional neuroleptics, amisulpride, risperidone) and those that are more prolactin-sparing (clozapine, aripiprazole, olanzapine). An American study indicated that 18% of men and 47% of women treated with antipsychotics for severe mental illnesses had prolactin levels above the normal range. Hyperprolactinemia is actually more common in women than in men. While sometimes asymptomatic, higher prolactin levels lead to more clinical manifestations in patients. Some symptoms result from hypogonadism caused by prolactin disrupting the hypothalamus-pituitary axis, while others stem from direct effects on target tissues. As a result, patients may suffer from sexual dysfunction, infertility, amenorrhea, gynecomastia, or galactorrhea. Data suggests these symptoms are frequent, yet patients rarely mention them spontaneously, and clinicians often underestimate their prevalence. Long-term, hypogonadism involves premature bone loss in both men and women. Klibanski and colleagues demonstrated that this loss is only significant in women with hyperprolactinemia associated with amenorrhea, suggesting prolactin itself may not be directly responsible for this specific feature. However, prolactin does seem to play a role in the development of breast cancer, though its connection to prostate cancer remains unclear.

I'll have to figure out my next move. I'm not even sure when my next check-up will be—given how much COVID is still flaring up lately—so I'll probably just wait for my doctor to taper my dose down himself. That will likely happen once I finish all 24 injections (I have 5 left).
I might be rambling a bit—and I know I can be a little much sometimes—but I truly feel like we should be leaning on one another more. This space is such a gift because we can be totally anonymous while we talk about the things that are actually weighing us down. Maybe I just have this deep-seated need to vent, but honestly, there’s something so healing about being heard—especially when someone actually takes the time to respond. 🙂

Antipsychotics are basically known for tanking your dopamine—that’s their main job, right?—and because of that, your prolactin levels end up spiking. Since dopamine and serotonin kind of have this inverse relationship (like how you lose your libido on SSRIs), I guess the same thing is happening with antipsychotics. That’s probably why such a huge chunk of people dealing with schizophrenia smoke; they're just trying to ease those symptoms caused by the dopamine crash. I honestly don't know if there's even an antipsychotic out there that targets dopamine without absolutely killing your sex drive too. The only thing I can really think of is maybe asking if you can drop your dose a little. Obviously, don't go changing anything on your own, but I'm not sure what else you could even do.

Regarding the high prolactin thing... that can actually be what causes low libido or sexual dysfunction in guys, especially if there's a pituitary tumor involved. Usually, doctors prescribe dopamine agonists as a medical fix to shrink the tumor. But given what you're going through, that would probably be a total disaster since dopamine is also what's responsible for managing those positive symptoms.

mistynomad12 said:Antipsychotics are basically known for tanking your dopamine—that’s their main job, right?—and because of that, your prolactin levels end up spiking. Since dopamine and serotonin kind of have this inverse relationship (like how you lose your libido on SSRIs), I guess the same thing is happening with antipsychotics. That’s probably why such a huge chunk of people dealing with schizophrenia smoke; they're just trying to ease those symptoms caused by the dopamine crash. I honestly don't know if there's even an antipsychotic out there that targets dopamine without absolutely killing your sex drive too. The only thing I can really think of is maybe asking if you can drop your dose a little. Obviously, don't go changing anything on your own, but I'm not sure what else you could even do.

Regarding the high prolactin thing... that can actually be what causes low libido or sexual dysfunction in guys, especially if there's a pituitary tumor involved. Usually, doctors prescribe dopamine agonists as a medical fix to shrink the tumor. But given what you're going through, that would probably be a total disaster since dopamine is also what's responsible for managing those positive symptoms.

You summarized that perfectly. It seems to me that roughly 70% of patients diagnosed with schizophrenia smoke—I’m actually a former smoker myself—but it really isn't a healthy way to cope, especially when dealing with negative symptoms. I believe the real solution lies in maintaining a healthy lifestyle: a balanced diet, and supplementing with Vitamin D3, Omega-3s, magnesium, and B-complex vitamins. Physical activity is always a plus, along with practicing kindness, empathy, and staying social. It's all about boosting those "happiness hormones" naturally.

Some antipsychotics trigger prolactin issues more than others, while some barely touch it at all. Ultimately, a psychiatrist's primary focus is treating the mental illness, so it often comes down to their specific clinical perspective. For eighteen years, I was on monotherapy with Zyprexa—which is almost a gold standard for anyone with schizophrenia—but I could never quite feel right on it. My doctor kept insisting, "You're doing fine, this medication is working well for you."
Now, I'm on a combination of two antipsychotics. I did experience a relapse, though thankfully it wasn't a full-blown one, but I actually find I have much more drive for physical activity now. I can see clearly that I feel better on this combination than I ever did on monotherapy. It makes this way of life much easier to accept; previously, my only thought was how to stop taking the meds altogether just to prove I didn't need them. So, everything has its pros and cons. I suspect that, over time, we will eventually be able to reduce the dosage—which is likely the best outcome we can hope for. 🙂
All in all, being a "schizo" isn't quite as bad as people make it out to be. 😁

Just thought I’d bump this thread back up to the top.
I’ve been stuck in this sort of heavy lethargy lately—feeling pretty depressed, too—and honestly, it feels like even my 50 mg dose of Seroquel at night is just way too much for me right now. I think I’m going to drop down to 25 mg for a few days just to see if I can find a little spark of life again. I'm not dealing with any psychotic symptoms, but then again, there isn't much "life" left to speak of either. I’m sleeping about 12 hours a day, and even during those other 12 hours, I just feel completely exhausted. It's like being a dead man walking. I really don't think being a zombie is the point of treating schizophrenia with antipsychotics.

Harold Anderson3 said:Just thought I’d bump this thread back up to the top.
I’ve been stuck in this sort of heavy lethargy lately—feeling pretty depressed, too—and honestly, it feels like even my 50 mg dose of Seroquel at night is just way too much for me right now. I think I’m going to drop down to 25 mg for a few days just to see if I can find a little spark of life again. I'm not dealing with any psychotic symptoms, but then again, there isn't much "life" left to speak of either. I’m sleeping about 12 hours a day, and even during those other 12 hours, I just feel completely exhausted. It's like being a dead man walking. I really don't think being a zombie is the point of treating schizophrenia with antipsychotics.

What antidepressants are you taking?

frozengardener7 said:What antidepressants are you taking?

It’s just like a local news site and its comment section.